II 

118TH CONGRESS 

2D SESSION S. 5203 

To require the Secretary of Health and Human Services to issue guidance 

on best practices for screening and treatment of congenital syphilis 

under Medicaid and the Children’s Health Insurance Program, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2024 

Mr. HEINRICH (for himself, Mr. WICKER, Mr. KELLY, and Mr. BRAUN) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To require the Secretary of Health and Human Services 

to issue guidance on best practices for screening and 

treatment of congenital syphilis under Medicaid and the 

Children’s Health Insurance Program, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Maternal and Infant 

5 Syphilis Prevention Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) In 2022, there were 207,255 total syphilis 

2 cases in the United States, representing an 80 per3 cent increase since 2018 and continuing a decades4 long upward trend. 

5 (2) Untreated, syphilis can seriously damage 

6 the heart and brain and can cause blindness, deaf7 ness, and paralysis. 

8 (3) The increased rise in syphilis cases is caus9 ing the rise in congenital syphilis with more than 

10 3,700 cases documented among newborns in 2022, 

11 more than 10 times the number diagnosed in 2012. 

12 (4) When transmitted during pregnancy, con13 genital syphilis can cause miscarriage, lifelong med14 ical issues, and infant death. Congenital syphilis can 

15 present health issues for babies at birth, including 

16 neonatal death, meningitis, anemia, and problems 

17 with the spleen and liver. If not treated, congenital 

18 syphilis can cause bone and joint problems, vision 

19 and hearing problems, issues with the nervous sys20 tem, and developmental delays. 

21 (5) High incidence rates of congenital syphilis 

22 are often due to lack of timely testing or inadequate 

23 treatment during pregnancy. Timely syphilis testing 

24 and treatment during pregnancy might be able to 


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1 prevent almost 90 percent of congenital syphilis 

2 cases. 

3 (6) Requirements for syphilis screening among 

4 pregnant women varies by State. The majority of 

5 States require syphilis screening in the first visit, 

6 significantly less States require syphilis screenings 

7 during the third trimester or at delivery. 

8 (7) Screening during the third trimester and at 

9 delivery can lead to earlier detection of congenital 

10 syphilis and prevent adverse health outcomes for 

11 mothers and newborn infants. 

12 (8) Increased awareness and education are crit13 ical in reducing syphilis among pregnant women to 

14 prevent congenital syphilis. 

15 SEC. 3. GUIDANCE AND TECHNICAL ASSISTANCE UNDER 

16 STATE MEDICAID PROGRAMS AND STATE 

17 CHIPS. 

18 (a) IN GENERAL.—Not later than 12 months after 

19 the date of enactment of this section, the Secretary shall 

20 issue guidance to State agencies responsible for admin21 istering State Medicaid programs, State CHIPs, or both 

22 such programs, the Indian Health Service, Indian Tribes, 

23 tribal organizations, and Urban Indian organizations, on 

24 best practices with respect to actions that State Medicaid 

25 programs, State CHIPs, Indian health programs, and 


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1 urban Indian health programs operated by an urban In2 dian organization pursuant to a grant or contract with the 

3 Indian Health Service pursuant to title V of the Indian 

4 Health Care Improvement Act (25 U.S.C. 1601 et seq.) 

5 may take, including by using waivers under section 1115 

6 of the Social Security Act (42 U.S.C. 1315) and authori7 ties under title XIX of such Act (42 U.S.C. 1396 et seq.) 

8 and title XXI of such Act (42 U.S.C. 1397aa et seq.), 

9 for the following purposes: 

10 (1) Improving access to expand syphilis screen11 ing for pregnant women and babies. 

12 (2) Best practices for educating medical profes13 sionals and pregnant women with respect to syphilis. 

14 (3) Strategies for integrating telehealth services 

15 and training for providers and patients on the use 

16 of telehealth, including working with interpreters to 

17 furnish health services and providing resources with 

18 respect to congenital syphilis in multiple languages. 

19 (4) Best practices for increasing testing for 

20 syphilis in the third trimester and at delivery. 

21 (5) Improving treatment for syphilis and con22 genital syphilis. 

23 (b) DEFINITIONS.—In this section: 

24 (1) INDIAN TRIBE, TRIBAL ORGANIZATION, 

25 URBAN INDIAN, URBAN INDIAN ORGANIZATION, INVerDate Sep 11 2014 19:43 Oct 09, 2024 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S5203.IS S5203

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1 DIAN HEALTH PROGRAM.—The terms ‘‘Indian 

2 tribe’’, ‘‘tribal organization’’, ‘‘Urban Indian’’, 

3 ‘‘Urban Indian organization’’, and ‘‘Indian health 

4 program’’ have the meanings given those terms in 

5 section 4 of the Indian Health Care Improvement 

6 Act (25 U.S.C. 1603). 

7 (2) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 (3) STATE.—The term ‘‘State’’ has the mean10 ing given such term in section 1101(a)(1) of the So11 cial Security Act (42 U.S.C. 1301(a)(1)) for pur12 poses of titles XIX and XXI of such Act. 

13 (4) STATE CHIP.—The term ‘‘State CHIP’’ 

14 means a State child health plan for child health as15 sistance under title XXI of the Social Security Act 

16 (42 U.S.C. 1397aa et seq.), and includes any waiver 

17 of such a plan. 

18 (5) STATE MEDICAID PROGRAM.—The term 

19 ‘‘State Medicaid program’’ means a State plan for 

20 medical assistance under title XIX of the Social Se21 curity Act (42 U.S.C. 1396 et seq.), and includes 

22 any waiver of such a plan. 

23 (c) REPORT TO CONGRESS.—Not later than 2 years 

24 after the date of the enactment of this Act, the Secretary 

25 shall submit to the Committee on Energy and Commerce 


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1 of the House of Representatives and the Committee on 

2 Health, Education, Labor and Pensions of the Senate, and 

3 shall make publicly available, a report analyzing the imple4 mentation of the best practices described in subsection (a). 

Æ 


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